52D2185840 CLIA NUMBER - CONCENTRA - KENOSHA

Laboratory Demographics

  • CLIA Code: 52D2185840
  • Facility Name: CONCENTRA - KENOSHA
  • Facility Address: 6302 75TH STREET
    KENOSHA, WI
    ZIP 53142
  • Facility Phone: 262 771-0770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JESSICA PERSE
  • NPI Number: 1275159147
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2185840
LAB Type Physician Office
Facility Name CONCENTRA - KENOSHA
Street 6302 75TH STREET
City KENOSHA
State WI
ZIP 53142
Phone 262 771-0770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director DR. JESSICA PERSE

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This page was last updated on: 9/29/2025